Allergic rhinitis: An indicator of Otitis Media with Effusion in children seen at Aminu Kano Teaching Hospital, Kano

Abstract

Background: Allergic rhinitis (AR) is a multifocal IgE-mediated type I hypersensitivity reaction involving nasal mucosa characterized by excessive sneezing, watery rhinorrhea, nasal itching, nasal stuffiness and eyes itching. Tympanometry is a simple, rapid and objective test that can be easily carried out. The use of tympanometry in clinical setting can improve detection of middle ear effusion and other middle ear abnormalities. AR has been found to be one of the predisposing factors to developing Otitis Media with Effusion (OME) in children. Aim: To determine the prevalence of Otitis Media with Effusion among children with allergic rhinitis seen at Aminu Kano Teaching Hospital. Patients and Method: A case control study was used to determine the prevalence of OME among children with allergic rhinitis as cases and those without allergy as controls. The study participants were children aged 4-12years with clinical diagnosis of AR attending Ear, Nose and Throat (ENT) clinics of Aminu Kano Teaching Hospital, while controls were children age 4-12years without history of allergic rhinitis, ear diseases or other respiratory system related ailments attending general outpatient clinics in Aminu Kano Teaching Hospital. An interviewer administered score for allergic rhinitis (SFAR) questionnaire was filled out for all the participants, those with score of 6 and above were selected as cases. The two groups had complete ENT examination and tympanometry done, findings were recorded and analyzed using SPSS version 21. Results: The mean age of the cases was 6.8±2.1years while it was 7.5±2.6years for the controls. The mean difference was 0.7 and was not statistically significant (t=2.35, df=258, p-value =0.20). Type B tympanogram suggesting OME was found in 7.3% of subjects and in 2.8% of controls. Type C tympanogram suggesting negative middle ear pressure was found in 15.5% of subjects and in 4.6% of controls. Type A tympanogram suggesting normal middle ear pressure was found in 75% of subjects and in 90% of controls. Acoustic reflex was found to be absent in 29.6% of subjects and in 15.4% of controls and this found to be statistically significant (χ2 = 7.77, df = 1, p value = 0.001). The difference between type A, B and C tympanograms of subjects and that of controls was found to be statistically significant (Type A χ² = 14.62, df = 4, p value = 0.01, Type B χ² = 14.06, df = 4, p value = 0.01, Type C χ² = 17.01, df = 6, p value = 0.01). Type B tympanogram was used as an indicator to suggest OME for the purpose of this study. Conclusion: Participants with allergic rhinitis were found to have more abnormalities of tympanometric parameters and higher prevalence of type B tympanogram suggesting OME than controls.